the lucas center
Dr. Lucas' extensive background in cranio-facial surgery allows him to advise clients and perform a full range of facial rejuvenation procedures.

Baptist West Plastic Surgery's facial rejuventation services include Endoscopic Brow Lifts, Eyelid Rejuvenation,

Midface and Face Lifts, Nasal Surgery, and Ear Surgery. Dr. Lucas' aforementioned background in cranio-facial surgery also allows him to perfom a full range of Facial Skeleton Enhancements.

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Dr Lucas Now Offers Sculptra Aesthetic
Sculptra Aesthetic is indicated for the correction of shallow to deep nasolabial fold (smile lines) contour deficiencies and other facial wrinkles which are treated with the appropriate injection technique in healthy people.

Sculptra Aesthetic is a new type of facial injectable made from poly-L-lactic acid, which helps to replace lost collagen. It helps correct shallow to deep facial wrinkles, and folds, that appear with aging by replacing lost collagen. The main ingredient is a biocompatible, biodegradable synthetic material that has been used by physicians for decades.

Collagen is a key structural component that keeps skin youthful looking and smooth. As you age, your body's collagen production decreases, and you may begin to see wrinkles. Sculptra Aesthetic works to correct shallow to deep facial wrinkles and folds, as it replaces lost collagen, which can help provide a refined, more youthful looking appearance.

Sculptra Aesthetic works to replace lost collagen in a series of treatments. On average, three injection sessions are needed over a period of a few months. The number of injection sessions and the number of injections per session vary from person to person.

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Face and Neck Lift
Restoring balance to the face is key to the rejuvenation process. The youthful face has projection of the cheeks with a fat pad being situated near the cheek bone prominence. The jaw line is sleek and sculpted with an acute line angle with the neck and chin. It has been described that the face in youth has a pyramid shape with the base at the cheek bone region and the apex at the chin point. With aging and gravitational descent of the fat pads, atrophy of subcutaneous fat below the cheek bones and drooping of the skin overlying the jaw line, the pyramid changes by 180 degrees with the base at the sagging jaw angles and the apex at the nose with loss of volume around the cheek area.

The process of restoring balance to the face is dependent on the individual face, skin quality, and the underlying skeletal features of the face. Frequently the neck lines need to be corrected with tightening the underlying support mechanism of the neck and lower face. Traditional face lift techniques tend to have a more lateral vector of repositioning the skin and fat. Deeper plane techniques may help to improve the overhang of skin and fat around the nose and lips. A midface lift which releases the full thickness of skin and muscles off the facial skeleton at the level of the cheek bone can allow the appropriate vertical vector to restore the pyramid of youth to normal proportions often times in conjunction with endoscopic brow lifts.

Endoscopic Brow Lift
In facial analysis, it is helpful to divide the face into various aesthetic units. The zone of the forehead and its impact on the zone involving the eyes is a very important aspect in conveying youthful beauty of the face. Certain people have overactive muscles of the forehead leading to a worried look. Some even consider these overactive muscles to be an etiology of migraine headaches.

Another aspect of this zone of the face is the loss of skin elasticity and the effects of gravity. These two factors result in the descent of the eyebrows and give the region of the upper eyelids a droopy, tired look.

Endoscopic Brow Lift is a technique that plastic surgeons may employ to release the skin and muscles as a unit off the forehead and reposition to a higher level normal in youth. Through five small incisions hidden in the hair line, an endoscopic camera and instruments can be introduced to release the forehead skin. In addition, if there are overactive muscles leading to deep furrows in the brow, they can be weakened non-invasively through the above incision to create a smoother forehead. By determining the correct vector at which the brows are re-instated to a preferred position can also have a positive impact on how the upper eyelids appear. There are situations that may require upper and or lower eyelid surgery to complete the rejuvenation process. This can be discussed on an individual basis with a complete consultation.

Nasal Surgery
The nose, by virtue of the position on the face, has a major impact on profile and balance with the rest of the facial features. It may appear excessively large if grouped with other aspects of the face that may be deficient in size such as a small upper jaw or a chin point that is retruded with respect to the rest of the face. Careful facial analysis is necessary to give appropriate advice for an individual treatment plan. Because of his experience in dealing with complex facial reconstruction, Dr. Lucas is especially qualified to advise patients in this matter.

Another important aspect of nasal surgery is the understanding of the functional anatomy of the external and inner workings of the nose. Only then can an appropriate treatment plan be formulated for the individual.

As in other aspects of facial aesthetics, placing the nose in balance with surrounding structures is critical. Key aspects include shaping the nasal dorsum and keeping it proportional to the nasal tip projection, providing sculpted features without creating an over-resected appearance which can be a glaring reminder to the observer that a nose has been operated on in the past.

Facial Skeletal Augmentation
Procedures include:

  • Cheek Implants
  • Chin Implants and enhancements of other aspects of the lower jaw
  • Genioplasty

This is an area of aesthetic plastic surgery often overlooked by many surgeons because of their lack of experience in this field. Because of Dr. Lucas's extensive background in craniofacial surgery, he has a unique ability to evaluate patients and perform these unique procedures with precision.

In evaluating a face for rejuvenation or for harmonizing the proportions of the face, it is important to analyze the underlying skeletal support. When patients are unhappy about their facial appearance but cannot describe exactly what they don't like about their features, this is often related to an imbalance of the face. For example, a patient may have an overly prominent a nose with a small chin, excessive showing of teeth with high smile line related to a long upper jaw, a very flat face with lack of cheek projection related to a deficient upper jaw with respect to the rest of the face, or an aged-looking neck which might indicate a small chin that cannot adequately support the neck's soft tissues. This depth of analysis should be considered when discussing facial rejuvenation or nose surgery.

Cheek Implants can be a relatively simple procedure with all incisions restricted to the mouth under the lip. Dr. Lucas utilizes an implant material called Medpore, a compound which is easily carved and can be customized to an individual's facial needs. Cheek implants are secured with a single tiny titanium screw. This procedure can camouflage a deficient upper jaw and enhance soft tissue support of the cheek area giving a face a more balanced and youthful appearance. This concept can be extended to the area at the base of the nose which can provide added support to the upper lip giving a fuller appearance.

The chin is an important feature of the face and, if deficient, can make the lower face (from a point just below the nose to the bottom of the chin) appear small. Skeletal deficiency in this area can make the soft tissues of the neck seem excessive and even a young teenager can have the appearance of an old-looking neck. Additionally, it can cause the nose to appear to be too prominent. In these circumstances, some surgeons would opt for a chin implant. However, in Dr. Lucas's experience, while chin implants can be indicated in a few situations, a genioplasty will frequently give a superior result. Chin implants can only make the chin larger in one dimension, but a genioplasty can change the chin not only horizontally but also vertically. In addition, this procedure, which is performed through the inside of the mouth, advances the bone of the chin and moves the soft tissues of the neck forward, giving a new neck line with the chin enhancement. This procedure can be performed easily within one hour, with little down time. Besides the chin, other aspects of the lower jaw can be accentuated, including the angles of the jaw, giving a more prominent appearance to the lower face. (Click Here for Diagram)

In summary, these are safe procedures which are predictable, can be performed without scars to the face, and can greatly harmonize features, instilling natural beauty through a balanced face.

Ear Surgery
-Prominent Ear Deformity-

This condition occurs at birth and is related to a lack of development of the antihelical fold and or excessive conchal cartilage. Patients with prominent ears can endure social ridicule and decreased self- confidence. Dr. Lucas feels the time to intervene is around five years of age, a time when the ear has matured significantly but before most children become socially-conscious. Even adults who did not undergo surgical repair at an early age are candidates for surgery at any age.

The correction can be performed in an outpatient setting typically under general anesthesia and lasts about one hour for each ear. The general principal is to create an antihelical fold, and bring the conchal cartilage closer to the head. This can be a relatively easy procedure for the patient but can yield wonderful results.

Traumatic Earlobe Deformities
This is a frequent result of wearing excessively large earrings or from young children taking an interest in their mother's jewelry and yanking on the ear. This procedure can be performed in the office setting under local anesthesia. It requires freshening the margins of the cleft earlobe and closing edges together in conjunction with a local tissue rearrangement. It is recommended to defer re-piercing the earlobe for about three months.

Eyelid Rejuvenation
Eyes are one of the most important features in the identification of a face. The eyes, in concert with the lids and brow, convey a wide range of emotions. Often, the first signs of aging of the face can be seen in this region. The mechanism for closing the eyes and squinting are related to underlying muscles just under the fine skin of the eyelids. This constant muscle activity can lead to fine lines commonly known as "crow's feet." Also, the effect of gravity and loss of skin elasticity can lead to migration of fat normally hidden inside the eye socket resulting in protrusion through the eyelid skin. A condition that results in constant swelling of the eyelid skin in youth can lead to early changes of the skin giving a prematurely aged appearance.

The goals in eyelid rejuvenation include removing excess skin, sculpting the fat around the orbit, and ensuring a balance with the brows and cheek region. Not infrequently an endoscopic browlift may be recommended, depending on the physical findings. Click here for diagram of access sites

LEARN MORE ABOUT FACIAL REJUVENATION
Dr. Lucas is available to provide you with expert advice and personalized answers to all of your questions. Contact us online or give us a call at (865) 218-6210 to schedule a free personalized consultation.

More information from the American Society of Plastic Surgeons: